Chest swelling with adenopathy: Don’t forget tuberculosis

Tuberculosis (TB) of the chest wall is far less frequently encountered than pulmonary infection and represents between 1% and 2% of TB overall. We report the case of 24-year-old woman presented with a swelling on the right side of the chest, cervical and right supraclavicular adenopathy, anorexia and weight loss, over a period of 1 month. Chest computed tomography revealed an abscess in the right lateral chest wall. There were no pleuropulmonary or bone lesions. Biopsy of supraclavicular node showed nonspecific inflammatory lesions. Bacterial examination of needle aspiration biopsy specimen from the chest wall abscess disclosed Staphylococcus aureus. Despite adequate antibiotic, no improvement was obtained. After resection of the abscess, histopathological examination confirmed the diagnosis of tuberculosis and acid-fast bacilli grew on aspiration fluid. Tuberculosis infection should be considered if an infection process failed to respond to anti infectious agents.